grams. But I feel the American people are so mach mare inell geat and sensible that they are given credit for. They know the what it program was a binder Than the wee wee s government credinty and government decisionmaking The Ne is way when a government program ges underway as there s DUŠŠ DUDESSA the dissecting views are not listened to?

I respects the fan the those responsible for the swine fu pro gram acted in good faith. I think they made the best pademens they could. What I am concerned about is that once decisions were made so amme our population, a public relations campagn gr underway which ended up deceiving our people and leaving in las wake public diSYST

The only way to restore public trast is to dig into this program and find out what went wrong. In April. Secretary Califano an nounced a nanonal immunization program. We must learn from our mistakes in the past before we inaugurate a new immunization drive.

I think the swine fu program was the Federal Government's "Moby Dick" I think it was a great white whale that we pursued so doggedly that commonsense was lost sight of. The program was a terrible waste.

We thought it would cost $135 million, but it looks now like it will cost us well over $1 billion.

We thought a national immunization program would draw us all together in a national effort. This was to be a model for future immunization programs. Instead, we squandered the precious trust the public accords us.

Do you know what could be done with a $1 billion? We could provide all poor children with dental care. We could screen poor children for signs of mental retardation at an age when such a handicap is most easily treated. Can you conceive of how $1 billion could help programs for the handicapped of our Nation. Or how it could be used to modernize our veterans hospitals?

When I think what could be done with the funds we now must devote to cleaning up after the swine flu program I feel frustrated. With all our expertise, why didn't we know better?

I hope we can get answers to some of these questions in this hearing, and I want to thank the chairman for calling these hearings so that we can look into the issue of the swine flu immuniza tion program.

Mr. ROGERS. Mr. Maquire, did you have a statement?
Mr. MAGUIRE. No, Mr. Chairman.

Mr. ROGERS. We are pleased to have as our first witnesses the representatives of the General Accounting Office, who conducted the study requested by the committee. The witnesses are Mr. Gregory J. Ahart, Director of the Human Resources Division, General Accounting Office, who is accompanied by Jesse Flowers, Michael Burnett, and Peter Oswald, supervisory auditors of the General Accounting Office.

We welcome all of you gentlemen here. Your statement will be made a part of the record in full at this point and you may proceed as desired.

COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE

HARLEY O. STAGGERS, West Virginia, Chairman

CONTENTS

Statement of—

Abramson, Clarence A., senior counsel, Merck & Co. Inc

Page

411

4

Bailey, William O., president, Aetna Life & Casualty

438, 487

Ahart, Gregory J., Director, Human Resources Division, General Accoun ing Office

Biery, Richard M., M.D., on behalf of the United States Conference of City
Health Officers

Bradford, Windell, Administrative Assistant to Dr. Millar, Bureau of State
Services, Center for Disease Control, Public Health Service, Department
of Health, Education, and Welfare

Burnett, Michael, Supervisory Auditor, General Accounting Office
Elsea, William R., M.D., vice president, National Association of County
Health Officials (NACHO).

397

37, 96

4

384

Flowers, Jesse, Supervisory Auditor, General Accounting Office
Gemmell, Mike, legislative representative, National Association of County
Health Officials (NACHO)..

4

384

Goldbloom Irwin, Deputy Assistant Attorney General, Civil Division, Department of Justice

68

.........

Hagan, Charles F., general counsel, American Home Products Corp .411, 418
Harder, Henry U., president, Chubb & Son, Inc
Hendrickson, Robert F., vice president, operations, Merck Sharp & Dohme
Division, Merck & Co., Inc...

Jones, T. Lawrence, president, American Insurance Association......
Jordan, William, M.D., National Institute of Allergy and Infectious Dis-
eases, Department of Health, Education, and Welfare

Lamb, Frederick D., vice president and legal counsel, Merrell-National
Laboratories

438

411

438

37, 96

411, 426

Lloyd, Douglas S., M.D., on behalf of the Association of State and Territorial Health Officials (ASTHO).

379

Markoe, Frank, Jr., vice chairman, Board of Directors, Warner-Lambert
Co. (Parke-Davis)

411, 418

Meyer, Harry M., Jr., M.D., Director, Bureau of Biologics, Food and Drug
Administration, Department of Health, Education, and Welfare
Millar, J. Donald, M.D., Director, Bureau of State Services, Center for
Disease Control, Public Health Service, Department of Health, Educa-
tion, and Welfare..

37, 96

37, 96

Morris, J. Anthony, Ph. D., Greenbelt, Md

406

Oswald, Peter, Supervisory Auditor, General Accounting Office

4

Peterson, Neil R., Assistant Chief, Torts Section, Civil Division, Department of Justice

68

Additional material submitted for the record by—

American Insurance Association:

Attachments to Mr. Jones' prepared statement:
Insurance proposals-alternative No. 1, 2, and 3

450

Secretary Mathews' (HEW) telex to insurance companies dated
July 29, 1976........

453

454

Swine flu vaccine program

Memorandum dated November 10, 1976, to each subscribing
insurer-special liability insurance and special excess liability
insurance for vaccine manufacturers, national swine flu immu-
nization program of 1976 re claims administration procedures,
proposed implementation.

Servicing carrier agreement for insurers of the manufacturers of
vaccine

Additional material submitted for the record by-Continued

General Accounting Office, letter dated December 20, 1977, from Mr. Ahart to Chairman Rogers re correspondence concerning the scope of study; chronology of events and content of discussions which led to limiting the scope of evaluation of vaccine manufacturing costs; and for delayed study of vaccine manufacturing costs and agreement with requesting committees, with attached letters dated September 21, 1977, to Congressman Waxman and February 18, 1977, to Chairman John E. Moss, Subcommittee on Oversight and Investigations....

Health, Education, and Welfare Department:

Attachments to Dr. Millar's prepared statement:

Figure I-Percent of persons with history of receiving influenza
vaccine, United States, 1972-77

Figure II-Influenza vaccination coverage, percent by State as of
June 23, 1977

Figure III-Guillain-Barre syndrome attack rates in vaccinated
and unvaccinated groups by age, United States, October
1976-January 1977.....
Figure IV-Guillain-Barre syndrome attack rate for population
>17 years of age, by week of onset after A/New Jersey
influenza vaccination, United States, October 1976-January
1977

Figure V-Guillain-Barre syndrome relative risks for population
> 17 years of age, by week of onset after A/New Jersey influenza
vaccination, United States, October 1976-January 1977.....
Audit reports

"Evaluation and control of vaccines for the national influenza immuni-
zation program," report by Barry, et al

Table 1-Tests performed on influenza vaccine loss.....
Table 2-Summary of test results on commercial influenza vac-
cines

103

104

Table 3-Chicken cell agglutination (CCA) test results..... Table 4-Hemagglutinin content of A/New Jersey component of influenza vaccines as determined by immunoelectrophoresis...... 106 Table 5-Amount of vaccine as of December 16, 1976 Testing and distribution chart by doses and week ending Letter dated October 4, 1977, from Chairman Rogers to Secretary Califano re additional written questions with subsequent replies dated October 17, and December 13, 1977.... National influenza immunization program vaccine contract and insurance costs

105

107

108

354

Signing of letter contracts, with attachments pertaining to 1. tax
status of the self insurance retention fund; 2. production of "Shope"
influenza virus vaccine; and 3. waiver of cost accounting standards.

Justice Department:

Attachments to Mr. Peterson's prepared statement:

Claims received at Department of Justice

List of suits......

Correspondence between Chairman Rogers and the Department of
Justice re status of the 28 positions funded by a supplemental
appropriation made to meet the Department's specific request for
dealing with swine flu program claims

Letter dated December 13, 1977, from Irwin Goldbloom, Deputy Assis-
tant Attorney General to Chairman Rogers re list of all personnel in
the Civil Division who are presently working on matters arising out
of the swine flu program

Letter dated December 16, 1977, from Barbara Allen Babcock, Assis-
tant Attorney General to Chairman Rogers re cost per claim of
processing claims by the Justice Department under the swine flu
statute

National Association of County Health Officials (NACHO), attachment to
Dr. Elsea's prepared statement: NACHO survey on selected counties'
experience with the national influenza immunization program...
Statement submitted for the record by-

66

Public Citizen's Health Research Group, Anita Johnson and Sidney Wolfe,
M.D...

493

Appendix—““The Swine Flu Program: An Unprecedented Venture in Preventive Medicine," report to the Congress by the Comptroller General of the United States-June 27, 1977

ORGANIZATIONS REPRESENTED AT HEARINGS

Aetna Life & Casualty, William O. Bailey, president.

American Home Products Corp., Charles F. Hagan, general counsel.

American Insurance Association, T. Lawrence Jones, president.

Page

501

Association of State and Territorial Health Officials (ASTHO), Douglas S. Lloyd, M.D. Chubb & Son, Inc., Henry U. Harder, president.

General Accounting Office:

Ahart, Gregory J., Director, Human Resources Division.

Burnett, Michael, Supervisory Auditor.
Flowers, Jesse, Supervisory Auditor.

Oswald, Peter, Supervisory Auditor.

Health, Education, and Welfare Department:

Bradford, Windell, Administrative Assistant to Dr. Millar, Bureau of State Services, Center for Disease Control, Public Health Service.

Jordan, William, M.D., National Institute of Allergy and Infectious Diseases. Meyer, Harry M., Jr., M.D., Director, Bureau of Biologics, Food and Drug Administration.

Millar, J. Donald, M.D., Director, Bureau of State Services, Center for Disease Control, Public Health Service.

Justice Department:

Goldbloom, Irwin, Deputy Assistant Attorney General, Civil Division.

Peterson, Neil R., Assistant Chief, Torts Section, Civil Division.

Merck & Co., Inc.:

Abramson, Clarence A., senior counsel.

Hendrickson, Robert F., vice president, operations, Merck Sharp & Dohme Division.

Merrell-National Laboratories, Frederick D. Lamb, vice president and legal counsel. National Association of County Health Officials (NACHÓ):

Elsea, William R., M.D., vice president.

Gemmell, Mike, legislative representative.

Warner-Lambert Co. (Parke-Davis), Frank Markoe, Jr., vice chairman, Board of Directors.

United States Conference of City Health Officers, Richard M. Biery, M.D.